Fosamax

[Guest guest]

Ah, the wonders of pharmaceuticals . . .

 

[hsibaltimore.com]

 

Dear Reader,

 

If you were thinking about purchasing an 882-foot ocean liner, you

would

probably want one that wouldn't sink if it hit an iceberg. So if an

ocean liner salesman told you he had just the thing – guaranteed

unsinkable – except for one small caveat that it might sink if it

hits

an iceberg, you would probably tell him, " I'll get back to you

later. "

Later – as in " never. "

 

A patient who's considering the use of Fosamax (the medication that

prevents bone loss) might get the same sort of " get back to you

later "

feeling if she happens to come across a recent study in the New

England

Journal of Medicine that offers yet another reason to avoid this

medication like a leaky ocean liner.

-----------

Giving bones a break

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The Fosamax web site advises patients who use this drug to stay fully

upright for at least 30 minutes after swallowing a dose. This is

necessary to help the pill reach the stomach quickly, otherwise the

dose

may irritate or even ulcerate the esophagus, prompting heartburn and

possible chest pain.

 

But once Fosamax gets to the stomach and enters the blood stream,

some

users may wish they'd never swallowed it at all.

This past January, the FDA sent an alert to physicians stating that

biophosphonates like Fosamax may cause severe bone pain. But the

Fosamax

web site takes that warning even further, telling patients who use

the

drug to contact their doctor in the event of " severe bone, joint,

and/or

muscle pain. "

 

Biophosphonates increase bone density by tinkering with a remarkable

process that keeps bones strong and healthy. We tend to think of

bones

as static structures, hard as rock, but in fact our bones are alive

with

a constant turnover of osteoblast cells (which increase bone density)

and osteoclast cells (which remove bone). When biophosphonates

intrude

on this process – boosting osteoblasts by removing osteoclasts – the

complex natural balance is put at risk.

How much risk? According to Dr. Joseph Lane of Cornell Medical

College,

this drug that's supposed to protect bones may actually increase

fracture risk.

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Time for a holiday

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Based on previous research that shows a potential link between

prolonged

biophosphonate use and increased risk of thighbone fracture, the

Cornell

team examined a group of fifteen women who had used Fosamax for an

average of about five years. Each of the subjects had also

experienced a

thighbone fracture. Dr. Lane's analysis showed that ten subjects had

a

similar, very specific type of fracture. Among these ten, Fosamax had

been used for an average of more than seven years.

 

Dr. Lane explains to HealthDay News that slower bone turnover caused

by

biophosphonate use may prompt a gradual microdamage in the thighbone.

Over time this damage slowly takes its toll, making some patients

susceptible to fracture when they experience a fall – even a very

light fall from a standing position.

 

And then Dr. Lane tells HealthDay exactly what we've come to expect

in

studies that put a popular medication in a very poor light: Patients

who

take Fosamax should keep taking it. And he adds: " This is a great

drug

that does wonderful things. "

Right. Please ignore the heartburn, bone pain, and broken legs. (The

HealthDay article also notes that Fosamax was recently linked to

increased risk of irregular heartbeat.)

 

But after Dr. Lane completes his genuflection to this wonderful

drug, he

makes a suggestion that reveals something closer to reality: He tells

HealthDay that women who use Fosamax for a long period and have low

bone

turnover might want to talk to their doctor about taking a " bone

holiday, " and discontinue use for a year.

 

A bone holiday! Sounds nice. And while your bones are enjoying the

relief of a drug-free holiday, that might be a perfect time for a

nutrition makeover. In the e-Alert " Rags to Riches " (1/25/07), you'll

find several suggestions from Jonathan V. Wright, M.D., and HSI

Panelist

Allan Spreen, M.D., about the key nutrients necessary for optimal

bone

health, at this link:

http://www.hsibaltimore.com/ealerts/ea200701/ea20070125a.html

 

Sources:

" Atypical Fractures of the Femoral Diaphysis in Postmenopausal Women

Taking Alendronate " The New England Journal of Medicine, Vol. 358,

No.

12, 3/20/08

" Fosamax Linked to Unusual Femur Fractures " HealthDay News, 3/19/08,

nlm.nih.gov